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Control & Movement > Control L22 Posture and Gait > Flashcards

Control L22 Posture and Gait Flashcards

1
Q

What muscle groups are involved in standing posture?

A
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2
Q

What is hypotonia?

A

Reduced muscle tone = floppiness of limbs

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3
Q

What is hypertonia?

A

Aka spasticity which is increased muscle tone

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4
Q

What is bipedalism?

A

The act of moving on two feet

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5
Q

What are three parts of the appendicular skeleton that are often thought to be axial?

A

Scapula
Clavicle
Pelvis
They are appendicular skeleton NOT axial

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6
Q

What causes development of secondary curves (cervical and lumbar curves) in the spine?

A

Learning to sit up and walk as helps lower limb bear the weight of the trunk and neck weight of head

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7
Q

What is another name for a secondary curve if the spine (curve we develop after birth)?

A

Lordosis

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8
Q

What is another name for a primary curve of the spine (a curve we’ret born with)?

A

Kyphosis

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9
Q

How does the pelvis help with weight bearing?

A
  1. Weight of body is transferred centrally through the spine
  2. Distributed laterally at the pelvis via sacrum and ilia
  3. Weight transferred from the ilia through the femurs
  4. Pubic rami form struts (or braces) which help maintain integrity of the arch
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10
Q

What is the only joint connecting the upper limb to the axial skeleton? Why is this beneficial?

A

The sternoclavicular joint - allows large range of movement of upper limb

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11
Q

What joints/connections connect the lower limb and pelvis to the axial skeleton? What does this mean?

A

the sacraoiliac joint posteriorly
Pubic symphysis connects each hip bone anteriorly causing circular structure
This means the lower limb has less range of movement

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12
Q

How is the femur adapted to weight bear?

A

The femur is angled inwards towards the knee to bring the legs closer to the centre axis of the body allowing the knee and ankle joints to sit under the pelvis to improve weight bearing

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13
Q

What is a Q angle?

A
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14
Q

What direction does the patella usually dislocate?

A

Laterally

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15
Q

What can cause dislocation of the patella?

A
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16
Q

What is meant by the term plantigrade?

A

The whole length of the foot is set down on the ground

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17
Q

What is meant by the term digitgrade?

A

Standing and waking on toes

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18
Q

How is the human foot structured for weight bearing?

A

Calcaneus acts as a large weight bearing bone
Longitudinal and transverse arches distribute weight (act as a shock absorber)
Big toe is in line with the rest of the toes and is not opposable

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19
Q

What are the roles of the foot?

A

Provides stability = weight bearing, shock absorption and propels body through space
Probes flexibility

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20
Q

Where does the centre of gravity pass in humans when upright?

A
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21
Q

What muscles are active when a person is standing at ease?

A

Erector spinae
Iliopsoas
Plantar flexor muscles of the lower leg

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22
Q

When standing upright at ease, what position are the joints of the lower limb in?

A

Hip and knee joints are extended and supporting ligaments are taut so are in the most stable position

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23
Q

Which muscles protract the scapula?

A

Serratus anterior
Pec minor

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24
Q

Which muscles retract the scapula?

A

Middle fibres of trapezius
Rhomboid major
Rhomboid minor

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25
Q

What is the normal lumbosacral angle (at lumbral lordosis)?

A

30-45 degrees

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26
Q

What is the role of erector spinae?

A

Extension and lateral flexion of the spine

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27
Q

What is the role of psoas major?

A

Flexion and external rotation of the thigh

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28
Q

What movement occurs when the external and internal oblique muscles contract together?

A

Lateral flexion of the trunk

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29
Q

What is an example of a muscle that can forward flex the lumbar spine?

A

Rectus abdominis

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30
Q

What are the main muscle groups involved in flexion of the lumbar spine?

A

Rectus abdominis
Bilateral psoas major
Bilateral internal and external oblique

31
Q

What muscles are involved in anterior pelvic rotation/ tilt?

A

Erector spinae
Flexors of the hip
(Increasing lumbar lordosis)

32
Q

What muscles are involved in posterior pelvic rotation/tilt?

A

Rectus abdominis
Hip extensors
(Decreasing lumbar lordosis)

33
Q

What change in the lumbar spine is usually seen with people with chronic lower back pain?

A

Loss of lumbar lordosis

34
Q

What is a common cause of anterior pelvic tilt?

A

Wearing high heels

35
Q

What is the innervation of gluteus maximus?

A

Inferior gluteal nerve

36
Q

Where does gluteus maximus insert?

A

Iliotibial tract

37
Q

What everyday function is gluteus maximus in?

A

Climbing stairs

38
Q

What allows you to keep your hip straight/upright when you’re standing on the ipsilateral leg?

A

Gluteus medius and minimus bring hip down when standing on one leg

39
Q

What muscles are the abductors of the thigh? What innervated them?

A

Gluteus medius and minimus
Superior gluteal nerve

40
Q

What muscles flex the hip?

A

Iliopsoas
Tensor fascia latae
Rectus femoris
Pectineus
Sartorius

41
Q

What muscle can produce lateral (external) rotation of the thigh in an extended hip and abduction of the thigh in the flexed hip?

A

Piriformis

42
Q

What nerve supplies adductor magnus, adductor longus and Gracilis?

A

Obturator nerve

43
Q

What is the origin site of the hamstring muscles?

A

Ischial tuberosity

44
Q

What is the role of the iliofemoral ligament?

A

Prevents hyperextension of thigh at the hip preventing posterior tilt of the pelvis and the trunk falling forward when standing?

45
Q

What is the main action of the muscle group innervated by the deep fibular (peroneal) nerve?

A

Dorsiflexion of the foot at the ankle

46
Q

What common action do tibialis anterior and posterior share?

A

Inversion of the foot

47
Q

What muscles of the lower limb provide dynamic support for the arches of the foot when walking?

A

Tibialis anterior and posterior
Fibularis longus

48
Q

How can the knees be deformed in terms of posture?

A

Vagus deformity = distal part of knee points inwards
Varus deformity = medial part of knee moves outwards

49
Q

what is gait?

A

manner of walking

50
Q

what is the pattern of the gait cycle?

A

cyclic engagement of muscles and joints

51
Q

is everyone’s gait the same? If not how can they differ?

A

No - can differ by stride length, pelvic movement, upper body positioning/posture

52
Q

what can cause an abnormal gait cycle?

A

injuries to limb or torso
traumatic brain or spinal cord injuries
pain
connective tissue disorders
muscular disorderes e.g. muscular dystrophy
skeletal patholiges e.g. scoliosis
neural pathologies
pes planus
toe walking
extremes of weight

53
Q

what is an isotonic contraction?

A

a muscle change in length to produce movement

54
Q

what are the two types of isotonic contraction?

A

concentric - shortening the muscle
eccentric - lengthening the muscle

55
Q

what is an isometric contraction?

A

increase in tension of the muscle but no change in length and no movement.

56
Q

what are concentric contractions good for?

57
Q

what are eccentric contractions good for?

58
Q

what are isometric contractions good for?

59
Q

what are the two phases of the gait cycle?

A

stance phase - foot on the ground (60%)
swing phase - foot in the air (40%)

60
Q

when is there double support (both feet on the ground) in the gait cycle?

A

At the beginning and the end of the stance cycle - makes up 10% of the full cycle

61
Q

what are the 5 parts of the stance phase of walking?

A
  1. Heel strike
  2. Loading response
  3. Mid-stance
  4. Terminal stance
  5. Pre-swing
62
Q

what happens in the heel strike section of the stance phase of the gait cycle?

A

isometric contraction of gluteus maximus (preventing forward movement of the trunk on the hips)

eccentric contraction of the tibialis anterior to lower the forefoot to the ground in a controlled manner.

63
Q

what happens in the loading response section of the stance phase of the gait cycle?

A

weight transferred to stance limb as full contact of foot on the ground

eccentric contraction of quadriceps femoris stabilises the knee

Then concentric contraction of quadriceps femoris to extend the knee for midstance.

plantar flexors (gastronemieus and soleus) eccentrically contract to decelerate dorsiflexion to prevent the leg collapsing anteriorly.

64
Q

what happens in the midstance section of the stance phase of the gait cycle?

A

opposing limb swings past stance limb

isometric contraction of the hip abductors of hip on stance side (gluteus medius and minimus) stabilise the pelvis during this section

65
Q

what happens in the terminal stance section of the stance phase of the gait cycle?

66
Q

what happens in the preswing section of the stance phase of the gait cycle?

A

powerful concentric contraction of the plantarflexors of the toes to push them off the ground and accelerate forwards.

eccentric contraction of the hip flexors decelerate extension of the thigh at the hip.

67
Q

what happens in the initial and mid swing section of the swing phase of the gait cycle?

A

concentric contraction of hip flexors creates forward swing

concentric contraction of knee flexors (hamstrings) shorten the limb to prevent foot dragging on the ground

68
Q

what happens in the terminal swing section of the swing phase of the gait cycle?

A

concentric contraction of dorsiflexors (tibialis anterior) ensures toe clears the ground.

concentric contraction of quadriceps moves the flexed knee into extension

eccentric contraction of hamstrings decelerate the forward swing limb

69
Q

what minimises vertical shift of the pelvis in the gait cycle?

A

hip abductors

70
Q

what minimises lateral shift of the pelvis in the gait cycle?

A

hip adductors

71
Q

what prevents the pelvis from tilting when one leg is lifted off the floor i.e. you stand on one leg?

A

superior gluteal nerve innervates the hip abductors of the opposite side (the stance limb that’s in contact with the ground), contract and exert a pull on the pelvis on the stance side preventing tilt.

72
Q

why does gait change as we age?

A

reduction in velocity and stride length due to reduced muscle bulk, strength and flexibility + loss of hearing/vision

73
Q

in what direction will a patient get double vision if the abducens nerve is damaged?

A

looking to the side of the lesion i.e. if left abducens nerve is damaged then the patient can’t abduct the left eyeball to the left so, when looking to the left the right eye and left eye are looking in different directions as the right eye can adduct the right eyeball in that direction but the left cannot abduct to the left.

74
Q

what is most at risk with a fracture to the neck of the fibula?

A

common fibular nerve as it wraps around the fibular neck

Control & Movement (36 decks)

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